Operation Smile

Devout followers of this blog (thanks Mom and Dad!) might remember that in my very first post I linked to a segment of the Joe Rogan podcast in which Whitney Cummings, the guest, discusses her experience with an NGO called Operation Smile. Besides loving how Whitney describes her motivations for being involved, I really appreciated the organization she decided to work with as well. So when it was listed in the Peace Corps Ghana newsletter as an opportunity for volunteers, I immediately applied.

For those unfamiliar, Operation Smile is an American NGO (non-government organization, ie. an international not-for-profit) who works with doctors and volunteers from different countries to provide free cleft-pallet and cleft-lip surgeries to people, mostly children, in the developing world. They don't work with the Peace Corps in most

countries, but fortunately for me they have a history of working with PCV's (Peace Corps Volunteers) in Ghana and typically have two "missions" here each year. So of course I was elated when chosen as one of the 6 PCV's to work with Operation Smile and equally excited that this particular mission would take place in Ho, the capital of Volta Region (where I currently live).

The first task for each of us was to meet prospective patients at an assigned location around the country (different for each of us) and get them on pre-chartered buses to Ho. I was assigned Ridge Hospital in Accra and when I arrived at 6am that morning there were already dozens of patients and guardians ready to go. I took the list of patients out of my backpack, placed the backback down on the ground and started going through the people asking for names and directing them to the buses waiting for them down the road. People continued to arrive steadily over the next hour or two and by the time I circled back for my backpack, it was gone. My laptop, kindle, passport, and about as much money as I make in a month (the equivalent of ~$130) were all gone. Safe to say I felt extremely foolish for having ever put down the bag to begin with, let alone not keeping a watchful eye on it at all times but at that point it didn't matter. Some friendly people around me and hospital staff helped me look for the bag but I knew it was useless. And because it happened in a busy hospital, it could have been anyone. It's especially frustrating because this is after my phone broke twice, the 2nd time beyond repair just before the backpack was stolen, so I lost all my photos and music in one fell swoop.

Anyway, in typical Ghanaian fashion, people continued to arrive through about noon before we were finally given the okay but the Operation Smile team to leave Accra, making my rough morning that much more difficult. On the bus people were initially somewhat frustrated at having had to wait for 6, 7 or even 8 hours in the sun but also excited at being so close to having surgeries for their kids.

You see, in Ghana, magic and curses are very real things for many of its citizens, often referred to here as "juju". And when you have a child born with a cleft pallet or lip, your neighbors, and sometimes even your family, believe you to be cursed. The prospect that this will be fixed was enough to keep people in generally good spirits all morning despite the delays. This potentially life changing surgery continued to keep people generally positive all week as well, despite the conditions.

Speaking of which, we were all assigned to stay in a Senior High School just a mile or two down the road from the Hospital. However, we were sleeping in the classrooms and both space and resources tight. A single mother and her infant only received one mattress between them, which was not as big as a twin sized bed and not as thick as a ream of paper. It created some challenging conversations as we got them all situated, but ultimately it was a free place to stay with a potentially free surgery so we won most battles. It didn't help though that we ended up having in the neighborhood of 550 total people staying there, as opposed to the 350 they had last mission.

The role of the Peace Corps Volunteers was to live at the school with the rest of the families (all other volunteers stayed in hotels) and help manage the process of feeding them, transporting them and just generally keeping them entertained. I believe I have spoken before of the intimidating nature of a large group of Ghanaians, if only because of the difference in culture and perpetual spotlight you have on you. But in this instance, it felt very little like being at site. First, there were 5 other Americans there with me to share the attention. Also, there was constantly something to do to keep you distracted from everything else going on that might otherwise stress you. And then finally, you were there volunteering to help people to receive free surgeries, which meant people had much more reason to be on your good side than normal. Overall, it created an environment that I really enjoyed and already miss.

That's not to say it was wholly peaceful during the two weeks. Keeping people organized and disciplined while being fed was a surprisingly strenuous challenge. We learned hard lessons early on when we tried to assert American standards and practices onto the Ghanaians by having strict lines and an organized distribution of food to keep things fair. It was often chaotic and always a mess. When we finally stepped back and let them do it themselves, it ran a lot smoother. At that point we were able to slowly change things, meal by meal, to a more organized structure and finally they were forming lines all on their own by the last day. it was s hard lesson to learn, but one I'll never forget: You can't force your own values and ways of life on other people, it won't work.

In that same theme, whenever we gave out anything free - from mosquito nets to cups to milk powder, even t-roll (toilet paper) - it caused a constant stream of other people asking for that free item. And because we couldn't recognize everyone's faces or know who other volunteers had given things to, it became impossible to know who had received the item and who hadn't. We had a limited quantity of each item that we needed to make last so it became frustrating because we knew that people were regularly cheating us out of items we needed for later. This, of course, is another good lesson learned about the challenges of the development work that I've already begun to write about for my next blog (on paper since I don't have a laptop... ugh!). So stay tuned for that.

As a short anecdotal preview, one of the volunteers from Brazil bonded with one of the Ghanaian girls. When she was denied surgery (about 30-40% were denied for a variety of reasons from lack of nutrition to the problem being out of scope for the mission), she decided to give her a $100 bill. While I appreciate this volunteers initiative and don't judge her intentions, the face of everyone one of the PCV's was equally angered and worried. Because, as I'll explore in my next blog, giving things to people as a foreigner is both bad for the image of foreigners, which ultimately effects Ghanaian's attitudes towards self improvement and the West's role in their progress, and potentially harmful to the individual who benefits. That girl, who was there without a guardian, will now have extra cash when she heads home (assuming she can figure out how to exchange it) that will be noticed by her family and peers. It's unlikely she will actually get to keep the money and even if she did, there is little for her to benefit from in her village. The best case scenario is that the money is used for school fees and her family saves that money (assuming they were sending her to school). Given that she was there alone, even this will likely result in the family doing their job less because they don't need the short-term income and/or using the money for things like alcohol.

Before operation smile I had been whole-heartedly for "Voluntourism", like the trip Whitney Cummings made, and now I'm mixed. The surgeons, nurses and full-time Operation Smile staff excluded (who's value was literally irreplaceable), there were around 20 volunteers there for the two weeks who's main job, as far as I could tell, was to play with the kids at the hospital. On it's surface, this seems really positive to me. They get a glimpse of life in Ghana, expand their perspective, increase their cultural awareness and provide a generally positive image of Westerns. However, seeing it action made me question the value gained against the value lost. The truth was that they spent the majority of time taking pictures, mostly selfies, while leaving the kids each night, riding in their air-conditioned bus and staying in their nice hotels with hot showers and space for their belongings. Even just the constant image of their nice bags and sunglasses against the backdrop of typical Ghanaian wear was off putting. Some voluntourists I thought were overall valuable and seemed to take the experience seriously. But unfortunately, the vast majority of them seemed to lack the understanding of just how out of place they looked and of the potential damage they were doing to attitudes of Westerns. Yes, the parents were undoubtedly happy they were all there, but I fear all of them - especially the kids - will now have an impression of the West that we are all rich and happy and giving all the time. Again, I hope to address this more in the next blog.

The week did have a sad tone to it early on, not for any reason that could have been prevented. One of the volunteer surgeons unexpectedly died of a suspected heart attack. Hailing from Egypt and a regular Operation Smile Ghana volunteer, everyone involved had nothing but great things to say about him. What made the shock even more challenging for us PCV's is that they decided not to tell the patients or guardians. So the schedules obviously changed quickly and repeatedly after that so we were constantly on our toes, sometimes having to give bad news to people who were expecting surgery, all while dealing with the tragic news ourselves.

Ultimately, almost all the surgeries took place as scheduled or were simply postponed while just a few were canceled. They had 155 total surgeries performed, which I've been told is their 2nd largest total ever in Ghana. By nearly every measure, it was a complete success and I feel so proud to have been a part of it.